Dental Plan Basics: Knowing Which Plan to Choose

Which Dental Plan Do You Need?

For most consumers in the United States, dental insurance is an integral part of a well-balanced health care plan, usually ranking second only to medical insurance. But with all the dental plans that are available today, how can you know which one will be the best for you and the needs of your family?

There are many questions to ask yourself before choosing a plan, such as:

  • What type of routine dental care will be covered?
  • What major dental care/services are covered?
  • Does the plan cover diagnostic and preventive services?
  • What limitations will the policy place on pre-existing conditions, such as cracked/broken teeth or existing prostheses?
  • Is there a waiting period before major dental treatments?
  • Will I have a choice of treatment, or is the least expensive treatment required?
  • And so many more!

If you’ve found yourself on the hunt for the right dental plan but are unsure where to begin, browse through our guide of helpful dental plan basics. You don’t have to be an insurance expert to make an informed and confident decision!

1. Identify Your Needs

Your age and family history play a significant role in the type of oral health challenges you and your family may be faced with.

Generally speaking:

Ages 20-39
Of all the age groups, people that fall within this range typically experience the fewest oral health issues. Many people find that taking a preventative approach to their oral health by choosing an elemental dental plan that covers basic cleanings and regular checkups is sufficient for meeting their individual needs.

This age group is also the likeliest to have a family or to consider starting one in the near future. If you have children, you will benefit from a plan that encourages children to learn healthy oral habits from a young age.

Ages 40-59
At this middle stage in life, restorative operations, such as root canals, replacement fillings, and crowns become more necessary. To get the most out of your dental insurance, consider choosing a plan that will simplify the management of your oral healthcare by providing you with access to a network of expert resources and offering choices to help conquer any oral health complications. Also, compare plans and consider those that offer lower deductibles and higher annual maximums to ensure you receive the very best care available.

Ages 60+
As you reach the age of retirement, you are more likely than ever to experience more serious and/or chronic conditions. The plan you ultimately choose should offer assistance with managing the expenses associated with more problematic conditions, such as gum disease and decay. Dry mouth associated with medications and some chronic conditions is another common issue among people in this age group.

2. Know Your Options
Once you’ve identified your needs, find out what dental plans are available in your area. Now is the time to find out precisely what those plans cover, and to gain a clear understanding of each policy’s terms. Don’t pick the first policy you come across. By taking the time to compare several dental policies, you can get the best value for your money and have the assurance of knowing you will receive the best possible care.

3. Plan Evaluation

There are many factors that will affect which dental plan you choose, such as:

Never sign on with a carrier until you have verified all basic dental services will be covered under your plan. This should include: regular 6-month cleanings, gum disease, x-rays, in-depth checkups, and tooth decay treatments to include root canals, tooth scaling, and dental fillings.

Typically, dentists who partake in networks accept fees that fall substantially below retail. Also, the larger the network, the more likely it is your dentist is a participant.

Your decision should be based on more than just the expected monthly premium. A quality plan should also encourage customers to maintain their oral health care by encouraging preventative care to include basic cleanings and checkups. These practices help to reduce the long-term cost of dental services and could also possibly have a substantial long-term impact on your overall health and associated health care fees.

Costs to consider:

  • Monthly premium – the cost you will pay monthly for your insurance.
  • Deductible – most insured individuals will be required to meet their minimum deductible each y ear before their insurance will begin to cover the cost of their dental care. On average, annual deductibles range from $25-$50 per covered individual, but varied policy to policy.
  • Maximum annual limit – most carriers cap the amount of possible reimbursement in a year. This amount is usually $1,000-$1,500 per year.

Customer Care
As a customer, you need to feel confident you’ll be taken care of after signing your name to a specific plan. The best way to validate a carrier’s reputation is to research certain service statistics. This could include the urgency in which they answer their telephones, how quickly their claims get paid, and their efficiency at solving customer problems.

Benefit Enhancement
The U.S. Surgeon General’s office acknowledges a link between periodontal disease and the health care fees for certain medical conditions. If you suffer from health conditions that may benefit from having access to additional oral health care, many insurance carriers can add certain benefits to your plan for little to no increase in premium. This could apply to pregnant women and/or individuals who have diabetes, weakened immune systems, cardiac issues, a high risk of oral cancer, and several other systemic syndromes.

4. Make Your Family’s Oral Health a Priority
Regardless of which dental insurance carrier you ultimately decide on, making your family’s oral health a top priority is a choice you will never regret. People with dental coverage tend to maintain better lifelong dental habits than those without insurance, such as brushing twice daily with a fluoride toothpaste, regular daily flossing, and regular visits to the dentist. Children who learn healthy dental habits at an early age are much more likely to maintain these habits throughout the course of their adult life.

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